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Biomedical subjects

G Scollo-Lavizzari

Publications and source records attributed to G Scollo-Lavizzari.

At least 37 records · Page 2Linked to original sources
PubMed1987

Prognostic value of EEG in post-anoxic coma after cardiac arrest.

The authors themselves studied 26 patients. The EEGs were classified in terms of increasing severity in 5 categories. Incorporating over 400 cases from the literature, the authors correlated the initial EEG findings with the clinical outcome following cardiac arrest. Grade I EEG findings (normal alpha with theta-delta activity) imply a very good prognosis. A complete remission can be expected in most cases. Grade II (dominant theta-delta activity with detectable normal alpha) and grade III (dominant theta-delta activity without detectable normal alpha) findings have no definite prognosis. Grade IV [low-voltage delta, possibly with short isoelectric intervals; dominant, monomorphic, non-reactive alpha-activity (alpha coma); periodic generalized phenomena (spikes, sharp waves, slow waves with very low background activity)] and grade V (very flat to isoelectric EEG) findings have a very serious prognosis.

Adolescent↗
PubMed1987

[Value of the EEG in the prognosis of post-anoxic coma following cardiocirculatory arrest].

The EEGs of 26 patients who remained at least 6 hours in coma after cardiovascular arrest were analyzed. The first EEG was recorded within few days after reanimation, classified in a 5-grade scale of increasingly severe impairment and compared with the final clinical outcome. On the basis of the present study and of a review of 408 EEG findings reported in similar investigations in the literature we conclude that the EEG can be useful in predicting the outcome of patients in postanoxic coma states: the EEG should be recorded at earliest 8-12 hours but within 2 days after reanimation, a barbiturate intoxication and hypothermia should be excluded. The classification of the recordings in a 5-grade scale has proven to be helpful and accurate in predicting the outcome: Grade I EEG findings imply a very good prognosis, a complete remission can be expected in most cases. Grade II and III findings have no definite prognosis: the EEG should be repeated one or two days later, a favorable outcome is to be expected only with rapid improvement of the tracing. Grade IV and Grade V findings have a very serious prognosis: complete recovery has been described episodically, most in the pediatric population and with findings of alpha-coma.

Adolescent↗
PubMed1985

Benzodiazepine antagonist (RO 15-1788) in ethanol intoxication: a pilot study.

In 1983, we reported on the excellent efficacy of the benzodiazepine antagonist RO 15-1788 in cases of acute intoxication with diazepam in intensive care medicine. Upon observing a positive effect in a patient who had taken alcohol as well as diazepam a study aiming at establishing the beneficial effect of RO 15-1788 in alcoholic intoxication was started. In the meantime, we discovered a significant amelioration of the cerebral disturbance in patients suffering from hepatic coma by the same benzodiazepine antagonist. The preliminary results of a multicenter study reflecting the beneficial effect of RO 15-1788 in cases of alcohol intoxication will be presented.

Adolescent↗
PubMed1985

Benzodiazepine antagonist Ro 15-1788 in self-poisoning. Diagnostic and therapeutic use.

Thirteen patients with benzodiazepine overdosage received the specific benzodiazepine antagonist Ro 15-1788. Intravenous administration of 1.5 to 10 mg reversed the central nervous system depression induced by different benzodiazepine compounds within one to two minutes of injection. These case reports indicate that Ro 15-1788 may be an effective tool in the primary management of self-poisoning.

Adult↗
PubMed1984

[Prolonged coma caused by diazepam sedation in ventilated patients. Diagnostic and therapeutic use of the benzodiazepine antagonist Ro 15-1788].

Repeated administration of diazepam in two ventilated patients had caused drug cumulation and coma over several days. In both cases central nervous depression could be demonstrated by the benzodiazepin antagonist Ro 15-1788 which induced reversal of coma. Estimation of plasma concentrations in a 70-year-old female patient 150 hours after the last administration showed a diazepam concentration of 437 ng/ml and a desmethyl-diazepam concentration of 483 ng/ml. The calculated elimination half-life of these substances were 109 and 403 hours. In the second case benzodiazepin could be demonstrated in urine for 10 days after withdrawal of medication. These observations suggest that diazepam is not a suitable drug for prolonged sedation in artificially ventilated patients. The benzodiazepin antagonist Ro 15-1788 represents a valuable diagnostic aid in ascertained or suspect cases of benzodiazepin intoxications. It can also be used therapeutically for reversal of central nervous depression.

Aged↗
PubMed1984

The anticonvulsant effect of the benzodiazepine antagonist, Ro 15-1788: an EEG study in 4 cases.

An EEG study was carried out in 4 epileptic patients. In each case, Ro 15-1788 caused the disappearance or marked reduction of the epileptic potentials. In 1 case the patient had been pretreated with diazepam; in the other cases there had been no prior benzodiazepine treatment. In the first case, it is possible that Ro 15-1788 acted by abolishing a paradoxical effect of diazepam; in the other cases, we postulate an intrinsic anticonvulsant effect of Ro 15-1788. This investigation would suggest further study of Ro 15-1788 in epileptic patients for clarification of its anticonvulsant properties. In addition, evaluation of its action on the sedation caused by benzodiazepine antiepileptic medication is suggested.

Action Potentials↗
PubMed1984

How specific are periodic complexes in the diagnosis of herpes simplex encephalitis?

The specificity of localized periodic complexes (PC) in the EEG is discussed by means of a case. This patient presented rapidly evolving focal symptoms of the CNS together with fever. The EEG showed localized PCs and in the CT scan there was a hyperdense lesion in a region corresponding to the EEG finding. Postmortem examination revealed a subcortical bleeding in the temporal region. Possible mechanisms for the origin of these PCs and their diagnostic value are discussed.

Aged↗
PubMed1983

Hypnotic efficacy and clinical safety of midazolam in shift-workers.

The effect of 15 mg midazolam and 15 mg oxazepam compared with placebo was investigated in 12 shift-workers in a randomized cross-over sleep laboratory study with psychometric testing. Sleep latency was normal under all experimental conditions. Midazolam shortened the sleep latency, reduced the frequency of nocturnal awakenings, and increased the length of sleep stages 3 and 4. Both midazolam and oxazepam reduced the total waking time and prolonged the total sleep time. Neither of the two benzodiazepines negatively influenced performance after awakening. On the basis of these findings, midazolam would appear to be suited for the treatment of insomnia in shift-workers or of other situational sleep disturbances.

Adult↗
PubMed1983

First clinical investigation of the benzodiazepine antagonist Ro 15-1788 in comatose patients.

In medical practice a number of antagonists which are capable of abolishing the effect of endogenous substances are available. The discovery of the benzodiazepine antagonist Ro 15-1788 has opened up new possibilities in the treatment and diagnosis of comas of different aetiology. This compound makes it possible to shorten the duration of unconsciousness and to eliminate selectively the effect of the benzodiazepine in an organism which has been intoxicated by different substances. The benzodiazepine antagonist Ro 15-1788 occupies the benzodiazepine receptors in the brain and, without influencing the receptor itself, prevents an active benzodiazepine from binding to this site and from exercising its pharmacological effect. On the basis of 9 clinical examples in special situations, the efficacy of treatment using the benzodiazepine antagonist is presented and discussed.

Adult↗
PubMed1982

[EEG changes in a patient with acute intermittent porphyria and a Schwartz-Bartter syndrome (SIADH)].

A 24-year-old female with gastrointestinal disturbances, nausea and vomiting, had a convulsion with loss of urine and bitten lips on the 5th day of hospitalization. A significant decrease of sodium and potassium levels and lowered osmolality of the serum as well as urinary hyperosmolality permitted the diagnosis of the so-called syndrome of inappropriate antidiuretic hormone release (SIADH) of unknown aetiology, described by Schwartz-Bartter. Twice short tests for porphyria were negative; then the elevated porphyrin precursors collected in 24 h urine indicated the existence of an acute intermittent porphyria. A clinical follow-up and improvement were demonstrated by the EEG findings. Since animal experiments and pathohistological findings indicate that porphyrin metabolites such as delta-amino laevulinic acid and porphobilinogen may influence inhibitory and neurosecretory structures in central nervous tissue and interfere with GABA, cerebral hyperexcitability as well as disturbance of electrolytes may be explained. Finally, the question of whether the EEG changes are due to the significant electrolyte disturbances or are typical signs of acute intermittent porphyria is discussed.

Adult↗
PubMed1981

Frontal intermittent rhythmic delta activity. A comparative study of EEG and CT scan findings.

26 cases with frontal intermittent rhythmic delta activity (FIRDA) in the EEG are presented and compared to the corresponding results in computerized axial tomography (CT) of the brain. Selection was undertaken randomly without reference to special diagnostic aspects. Only 3 cases showed a deviation of the cerebral midline structures in the CT, because of a cerebral tumor. No deviation of the midline structures in the CT could be found in the other 23 cases, where FIRDA was the outstanding finding in the EEG. Thus, the conclusion may be drawn that FIRDA in the EEG is by no means indicative of subcortical lesions, especially tumors, with alteration of midline structures.

Brain Diseases↗
PubMed1980

Predictability of phenytoin serum levels by nomograms and clinicians.

On the basis of a reliable steady state phenytoin serum concentration on one (lower) dose, the serum concentration on a second (higher) dose was predicted in 28 patients (32 levels) by two previously reported nomograms and 3 physicians who had clinical experience with phenytoin therapy. Both nomograms and all 3 physicians on the average underestimated the serum concentration on the higher dose. Except for 1 physician, this bias was statistically significant (p < 0.05). The mean and SD of the prediction errors (difference between predicted and measured serum concentration) were -2.2 +/- 4.2 and -3.1 +/- 3.6 for the two nomograms and -1.0 +/- 4.0, -2.1 +/- 4.1 and -1.8 +/- 4.2 for the 3 physicians, respectively. Thus, independent of the method used, there was a large uncertainty in the prediction; the approximate 68% confidence interval of the prediction error (mean +/- SD) was almost as large as the therapeutic range of the drug. Because prediction of phenytoin serum levels based on one serum concentration measurement was found unreliable in this study, it is proposed that every patient whose dose had been increased should be under close observation until a new steady state has been confirmed.

Adult↗